Urinary Tract Infection

A urinary tract infection (UTI) is a bacterial infection that can occur anywhere in the urinary tract which includes kidneys, bladders, ureters and urethra. UTIs are found to be more common in women because their urethra is shorter and opens near the anus. About 3% of men in their 60s and 10% of men in their 80s are found to be prone to UTIs.

Infections become more common as old age approaches. Elderly people are more vulnerable to UTIs as their suppressed immune system makes them susceptible to infections. Another reason why the elderly may be more prone to UTIs is that weakened bladder muscles can lead to some amount of urine retention in the bladder during urination.

< Cloudy or bloody urine, which may have a foul or strong odour
< Low fever in some people
< Pain or burning with urination
< Pressure or cramping in the lower abdomen or back
< Strong urge to urinate even after the bladder has been emptied

The kidneys, ureters, urethra and bladder work together and get rid of urine. The kidneys process urine to remove extra liquid waste from the body. The ureters then carry the urine from the kidney to the bladder. The bladder stores the urine until it is passed from the urethra.

Infection happens when bacteria clings to the opening of urethra and begins to multiply. In women, the urethra is shorter and nearer to the anus as compared to men, and it gives bacteria living near the rectal area an easier passage to enter the body. After menopause, the skin around genital areas becomes fragile, affecting the passage of bacteria.

Bladder or kidney problems like kidney stones may lead to infections. Diabetes and constipation also increase the risk of UTI.

Most UTIs can be treated successfully. Bladder infection symptoms most often go away within 24 to 48 hours after treatment begins.

In the case of kidney infection, it may take more than a week to cure. If symptoms do not improve in spite of taking an antibiotic, another antibiotic may be needed because some bacteria are resistant to certain antibiotics.

A UTI can be diagnosed by a simple urinalysis. This test can usually diagnose the infection. It checks the white blood cells, red blood cells, bacteria and chemicals (such as nitrates) in the urine.

A clean catch urine culture test is done to detect the type of bacteria and determine best antibiotic treatment. A complete blood count test and blood culture tests might also be required to diagnose the possibility of a UTI.

If there is a recurring UTI and the kidney is affected, the doctor might suggest the following tests:

Usually, a course of antibiotic medicines clears the infection quickly. The antibiotics also help to prevent spreading of infection. Commonly used antibiotics include trimethoprim-sulfamethoxazole, amoxicillin, Augmentin, doxycycline and fluoroquinolones. Stronger antibiotics are needed in the case of a chronic UTI.

Usually, elderly people having kidney stones or change in the anatomy of urinary tract, and people having cancer, diabetes, multiple sclerosis or spinal cord injury may have to be admitted to the hospital.

Surgery might be needed in extreme cases.

< Keep the genital area clean. After passing stools, clean the area from front to back.
< Drink plenty of fluids and eat lots of fruit and fibrous food. This can help avoid constipation and promote easy bowel movement. Constipation increases the chances of urine infection.
< Do not drink fluids like alcohol and caffeine that tend to irritate the bladder.
< Wear cotton cloth garments and change them at least once a day.

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IndiaElderConnect is brought to you by Nightingales Medical Trust (NMT). Nightingales Medical Trust is a professionally managed not-for-profit organization based in Bengaluru working for the well-being of the elderly since 1998. The Trust strives to strengthen family bonds and promote community-based support systems, and provides a system of affordable and accessible services, thereby setting new trends in age care.